Latex Allergy

[kleinbbc]

I had my first latex case this past Friday. Pt needed a foley so I went and pulled latex free cath and separate bag with KY and other supplies. Later on my charge nurse pulled me to the side and ask me why I did what I did. I said the pt was latex allergy. She then told me you just open up a latex foley kit and pull the latex cath off the bag and replace with non latex cath. I had a hard time with this and would like some feed back..

Thanks

[core0]

omg!! i hope to high heaven i am never in the facility that david pa-c is working in.

in the past i have not repsonded to a latex ig-a rast (i was told there are many who do not respond to the test), thankfully all my docs have taken me seriously enough not to provoke a true airway emergency just to be able to 'document' the veracity of my allergy.

first of all, i don't make the rules, the hospitals do. they are based on evidence medicine. i would not agree that there are many that do not respond to an iga rast. there are people with selective iga deficency, but this is relatively rate with a rate of 1:400-2000. it is more common in people with autimmune diseases.

however, i do very silently have a decreased bp, o2 sat, and loc when exposed to latex that is in my vicinity. note - that is not contact and therefore really has very little to do with my underwear having any elastic.

please have the compassion to believe a patient who says they are latex allergic or sensitive - i'm not sure exactly what the difference is any way - the level of the previous mild reaction versus the next reaction which could be life-threatening?

not to mention that this protection could save you from a lawsuit which is probably a lot more expensive than the cost to take precautions.

documented airway reaction is one indication for latex precautions. not sure what you mean by silenty decreased o2 sat but this sounds like an anaphylactic reaction. in that case i would schedule it as a latex case. the reason that we ask about elastic is that its principal component is latex. patients that have a anaphylactic reaction to latex are counseled that they should not wear garments that contain latex. this is all part of the history that we gather to determine whether a patient needs to be on latex precautions or not.

practicing careful evidence based medicine with a good history and a good understanding of the patient is the way to avoid lawsuits (and practice good medicine).

david carpenter, pa-c

[Gidgette_gj]

so i too have had "contact dermatitis" and have recently began reacting to the the elastic on the iso gowns that we have at work. i had an appt last week with the allergist and my rast was negative!

so from experience/knowledge can some one tell me how concerned

i should be with this?

i think my problem is mostly denial, but am not getting over that any time soon, so i thought i would try talking about it!

i do have local reactions to certain foods...bananas and nuts....for instance.

also after hours at work i do have occassional chest tightness -wheezing though. and doe.

any thoughts, or words of support would be appreciated.

should i be getting a medical alert bracelet?

i am so frustrated over this!

thanks for listening!!

gidgette_gj rn

[Dragonnurse1, ASN, RN]

:bowingpur:You rock! I only wish that the people around here were as concerned for their patients as you. My last hospital stay hubby put No Latex sign on my door and the first question the nurse asked was - what does that sign mean:banghead:

You were correct in what you did. Next time ask the NM or the CN how are they going to defend a wrongfull death suit following a latex reaction that goes down the drain.

Patty former RN now latex allergic with Multi chemical allergies, and getting worse. Also neoprene allergic

[Dragonnurse1, ASN, RN]

Gidgette,

Most latex allergic patient have neg. rast test, also neg. ELISA test. There is no definative test for latex allergy, except your own reactions. Shop around for allergist that believes in latex allergy sx not test results. And either get a bracelet or some kind of alert.

Be your own advocate. There is lots of info on the LAforum site on Yahoo (no $ interest). They have links to sites that supply signs and other no latex things.

[BeeSunnyRN]

Gidgette,

You have to learn what you react to and what you are ok with. Some of us can take a little exposure to an allergen but you never know when the 'big one' is going to hit & you bite the old ET-tube.

My best advice, in addition to Dragon-nurse's advice, is to seek out a Dr. you are comfortable with. My original allergist just wanted to write a note stating I must avoid all latex/rubber. This is not anymore possible to do in a hospital or clinic setting than it is to do in real life. I tried to tell him that was too restrictive and he refused to see me again. I had to get a friend Doc to write that I needed to be able to control and limit my exposure to allergens so that I could continue to work. Thank God that friend was willing to stick his liability out there and write that note for accommodations otherwise I'd have been up a creek in a rubber row boat.

Look for alternative ways to use the products around you. Can you wear a t-shirt or something that comes between you & the elastic? Is that even something you can tolerate? If you're having respiratory symptoms that may not be enough because chances are it is still too close to your airway. Speak up and ask for alternative products to be stocked for your safety. It is the law that an employer must make reasonable accomodations.

The sooner you start protecting yourself the more likely you are to be able to decrease your reactions. Take care, do your research and starting advocating for yourself, your patients, and your fellow co-workers because you KNOW you aren't the only one.

stay safe,

bk

[nellie_nurse812]

You did the right thing....I have read documented reports of patients having allergic reactions to latex when only the latex particulates were in the air and not in contact with the patient.....

[Gidgette_gj]

I just wanted to say thanks to everyone that has replied so far!

It is really encouraging and at this time that is what I need!

I did conjur up the courage to talk to the medical director, and he is behind me 100%---yes I cried!

I don't want to leave my job as I love what I do, but in the same time it is extremely SCAREY!

So thanks for all the thoughts and keep them coming!

I am trying to be more aware of what I am around, and am praying that will do the trick!

I can only pray that everything will be ok, like you said you never know! I feel like everyday I am walking a tight rope!

Thanks so much for listening!

I really appreciate it!!

Gidgette:nurse:

[amiller126]

latex allergies are not taken seriously in most cases. my significant other has a severe latex allergy and her sister is an even worse allergy to latex.

i would have done exactly what you did.

[Dragonnurse1, ASN, RN]

:bow:To you amiller126 - It is bad enough when one person has the allergy but ya'll have to be twice as careful. My hubby has only the slightest reaction to latex adhesives. I hope he gets his kidney before the allergy gets worse.

Keep yourselves safe. If you don't no one else will:banghead:

Dragonnurse

[hypocaffeinemia, BSN, RN]

I just did some reading on this (http://www.emedicine.com/emerg/topic814.htm) and you're only going to see positive RAST's for those with type I reactions, which is the true latex allergy. Those with delayed reactions that are mainly topical in nature (type IV) aren't actually allergic to latex proteins but instead are allergic to some of the chemicals used in the manufacturing. Most people that have contact dermatitis as a result of latex aren't even experiencing an immune response at all.

Anyways, there's a thread around here somewhere about a new type of latex produced from some other plant that has initially been found not to evoke any sort of allergic response even in those severely allergic to latex. I hope these babies hit the market soon because my hospital only carries the nitrile exam gloves and I can't stand them.